早期颈动脉支架血栓形成所致短暂性脑缺血发作：经溶栓血栓切除术及全身应用阿昔单抗成功救治
Transient ischemic attack due to early carotid stent thrombosis: successful rescue with rheolytic thrombectomy and systemic abciximab.
作者信息
Bush Ruth L, Bhama Jay K, Lin Peter H, Lumsden Alan B
机构信息
Division of Vascular Surgery & Endovascular Therapy, Michael E. DeBakey Department of Surgery, Baylor College of Medicine and The Methodist Hospital, Houston, Texas 77030, USA.
出版信息
J Endovasc Ther. 2003 Oct;10(5):870-4. doi: 10.1177/152660280301000504.
PURPOSE
To describe a successful neurorescue technique in a patient with generalized seizures followed by hemiparesis immediately after carotid artery stenting (CAS) for a postsurgical restenosis.
CASE REPORT
A 65-year-old man with a symptomatic recurrent high-grade carotid stenosis after carotid endarterectomy was treated with CAS. The procedure was complicated by sudden transient ischemic attack caused by acute carotid stent thrombosis with clot propagation into the cerebral circulation. Percutaneous mechanical thrombectomy was performed with adjunctive infusion of intravenous abciximab, resulting in complete thrombus dissolution and resolution of neurological symptoms.
CONCLUSIONS
Access to a mechanical thrombectomy device was essential for rapid thrombus extraction, and adjunctive abciximab aided in residual clot dissolution. As a result of this combined method of clot removal, a disastrous outcome was averted.
目的
描述一种成功的神经挽救技术，该技术应用于一名在颈动脉支架置入术（CAS）治疗术后再狭窄后立即出现全身癫痫发作并伴有偏瘫的患者。
病例报告
一名65岁男性，在颈动脉内膜切除术后出现有症状的复发性重度颈动脉狭窄，接受了CAS治疗。该手术因急性颈动脉支架血栓形成并伴有血栓蔓延至脑循环而并发突然短暂性脑缺血发作。在静脉注射阿昔单抗辅助灌注的情况下进行了经皮机械取栓术，导致血栓完全溶解且神经症状消失。
结论
使用机械取栓装置对于快速取出血栓至关重要，辅助使用阿昔单抗有助于溶解残留血栓。由于这种联合血栓清除方法，避免了灾难性后果。
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